I am doing some research on electronic systems used by Research Ethics Boards in Canada. One of the models we are using to determine if systems are liked by ethics boards and their respective research communities is the
DeLone and McLean model. This model has been used a lot in information systems success studies and there is a lot of literature on it.
What there is not a lot of (to my knowledge), is how the model can be applied to eHealth applications. A little bit of searching on the internet and I discovered it has been used by the eHealth people at the University of Victoria in British Columbia, and I think it is very interesting what they have done. Roughly expressed by them is a Benefits Evaluation model. The team at UVic has applied this to evaluating Canada Health Infoway projects, called the
Infoway BE Framework. Coincidentally I recently read a CBC article that Infoway had saved a billionaire dollars by
implementing Electronic Medical Record systems for physicians in Canada. After reading some of the comments by the public on the CBC website for this story, I reminded again of the old adage that the Return on Investment in healthcare is improve in quality of life.
E-health records saved medical system $1.3B in 6 years
Use of electronic records more than doubled from 2006-2012, from 23% to 56%
Posted:
Apr 22, 2013 11:04 AM ET
Last Updated:
Apr 22, 2013 4:22 PM ET
A study done for Canada Health Infoway, the federally funded
organization set up to monitor and improve the use of information
technology across Canada's health care system, has found that increased
use of electronic medical health records has saved $1.3 billion over the
last six years.
The study by PricewaterhouseCoopers LLP (PwC) examined the switch to
electronic medical records (EMR) by family doctors from across Canada
between 2006 and 2012 and found:
- $800 million in
administrative efficiencies (less time by staff pulling and filing
charts or processing finding lab test results, less time by doctors
reading and maintaining paper files).
- $584 million in health system benefits (reduced duplicate diagnostic testing, reduced adverse drug events).
- Improved
chronic disease management and illness prevention (higher mammogram
screening rates, higher pneumonia and flu vaccination rates).
- Improved
communication amongst care providers and with patients (less time spent
repeating patient histories among care providers, electronic alerts
prompting follow-up care for things like medication recalls.)
The study's methodology included a review of current research, national survey and cost data and interviews.
"In some cases, it's the sum of a lot of little things, " said
Jennifer Zelmer, senior vice-president with Canada Health Infoway.
"When you're using electronic medical records, staff in a medical
practice tend to spend less time … pulling charts, and they're able to
use that time for clinical services," she added. "
And when you add that up those kinds of efficiencies, both in terms
of chart pulls and in terms of tracking down test results, actually the
value of that is quite significant."
The study's findings don't surprise Stephen McLaren, a family
physician in Markham, Ontario. He says many patients already understand
the efficiency of an electronic record, especially if their paper record
or test results were ever misplaced.
"Their visit with their provider is a very inefficient, unproductive
visit and very often means you have to come back," Dr. McLaren said.
McLaren says there's also better treatment of chronic illness because
electronic medical records allow a doctor to easily spot trends in a
patient's tests, over time.
"In the paper world, you have to flip through pages and pages and
pages, hoping to catch onto a trend if there was one there to see."
Use of electronic records still growing
Despite
the growing use of electronic medical records, only 56 per cent of
patients have one. McLaren says their use continues to grow, as more and
more patients ask for them.
Meanwhile, he says the next big step in this area is to link up
health care institutions — hospitals, labs, nursing homes, and doctors
offices — so that a patient's information can be shared more easily,
while still protecting the privacy of the data.
In a press release, Health Minister Leona Aglukkaq encouraged
provinces, territories and other stakeholders to keep working to
increase the adoption of electronic medical records and other e-health
technologies "so that Canadians can benefit from a better integrated
health care delivery system," added Minister Aglukkaq.
"We expect significant additional gains as adoption grows, use
matures, and connections to other care settings expand," said Richard
Alvarez, Canada Health Infoway's president and CEO, in the same release.
Canada Health Infoway had set a target for half of Canadians to have
electronic health records by the end of 2010. The federal government
delayed $500 million in funding for the agency by one year, seeking more information about how the contribution would be spent.
A 2009 report from the federal auditor general found
contracting and reporting problems in early efforts to move more Canadian health records online.
Our API directory now includes 37 health APIs. The newest is the DailyMed API. The most popular, in terms of mashups, is the Avvo API. We list 2 Avvo mashups. Below you’ll find some more stats from the directory, including the entire list of health APIs.
Health Minister Leona Aglukkaq (right), seen with
Richard Alvarez, CEO of Canada Health Infoway in 2009, announced $500
million in funding four years ago to improve the implementation of
electronic medical record systems, but the funding was held back for a
year until the government received more information about how it would
be spent. (Handout/Health Canada/Canadian Press)